Glossary

Glossary of helpful terms:

Achilles Tendon – The Achilles tendon is the tendon which connects the three strongest flexor muscles of the leg to the foot. It is a tendon which connects the two heads of the gastrocnemius muscle and the deeper soleus muscle to the calcaneus, or heel bone. The tendon can be felt in the back of the ankle and is just under the skin. This tendon is a common source of pain in runners and other athletes. Achilles tendonitis, tendonosis and rupture are some of the common problems encountered with this structure.

Ankle Instability – Chronic, repetitive sprains of the ankle. This can be due to an injury that never healed properly but can also be due to weak ankle ligaments or a heel that tilts inward (varus heel).

Ankle Joint – The joint between the foot and the lower leg. It allows the foot to dorsiflex (move upward) and plantarflex (move downward). It is made up of the two bones of the lower le (tibia & fibula) and the ankle bone (talus). There are ligaments that hold the joint together on the inside (deltoid) and outside (lateral ankle ligament complex).

Arthritis – Arthritis typically refers to the wearing away of joint surfaces. Arthritis falls into one of three categories: Osteoarthritis is primary arthritis of the joint and may be related to family history. Traumatic arthritis is arthritis that develops after injury to a joint. Inflammatory arthritis occurs when a disease affecting the patient causes the cartilage to wear away. Treatment is dependent on the cause and extent of the arthritis and may include medication, bracing, physical therapy or surgery.

Calcaneus – The heel bone. Two joints are present: the subtalar joint which allows motion with the talus (ankle) bone which allows inversion and eversion of the foot with the leg; and the calcaneocuboid joint has a complicated biomechanical function that controls flexibility of the foot and controls the arch of the foot. The Achilles tendon attaches to the back of the calcaneus, and the plantar fascia also attaches to the bottom of the calcaneus.

Cartilage – Cartilage is a living tissue that lines our joints. It is a matrix of proteins and collagen that is tough, absorbs shock and is very smooth. Healthy cartilage can, and often does, last our whole life without problems. Disease of the cartilage or trauma can cause the cartilage cells to die. Unlike most tissues in our body, joint cartilage cells do not reproduce themselves once our skeletons are fully grown. Basic science and clinical research has led to recent innovations in cartilage transplantation and growth.

Congenital Vertical Talus (CVT) – A condition where the foot is malformed at birth. The ankle bone (talus) is not formed correctly and this condition frequently requires surgery. The foot may have a reversed arch or “rocker bottom” deformity where the middle of the foot sits lower than the heel and toes. This condition requires treatment by an orthopaedic surgeon.

Cuboid – The midfoot bone on the outside of the foot. This bone lies between the calcaneus and metatarsals. This bone may be crushed (“Nutcracker fracture”) when the midfoot is injured.

Eversion – Twisting out, away from the midline of the body.

Extensor digitorum longus – A foot extensor is a muscle which raises the toes or ankle. The extensor digitorum longus stabilizes the toes against the ground in push-off and propulsion.

Extensor hallucis longus – The extensor hallucis longus helps to stablize the first metatarasophalaneal joint (where the toes meet the foot) and forefoot during push-off.

Fibula – The most prominent bone on the outer side of the ankle that also extends to the knee.

Fracture – A fractured bone is one that has cracked or broken. Bones are comprised primarily of calcium and are quite hard. A crack usually occurs as a result of an injury. In cases of abnormal bone structure, a fracture can occur after a very minor injury. Overuse can cause a “stress” fracture. Displacement refers to the amount the two broken pieces have moved from each other. In non-displaced fractures the pieces of bone haven’t separated at all. Displaced fractures have some separation between the broken pieces. Some bones can heal properly even with a lot of displacement, but some fractured bones require surgery for even a small amount of displacement. Evaluation and treatment by an orthopaedic surgeon is necessary.

Inflammatory arthritis – Inflammatory arthritis occurs when a disease affecting the patient causes the cartilage to die off. Treatment is dependent on the cause and extent of the arthritis and may entail medication, bracing or surgery.

Inversion – Twisting in, towards the midline of the body.

Lateral malleolus – The end of the fibula, the most prominent bone on the outside of the ankle.

Ligament – A band of tissue that connects one bone to another, typically to support a joint. Ligaments are made primarily of collagen. Injury to a ligament is referred to as a sprain.

Medial malleolus – The most prominent bone on the inner side of the ankle.

Navicular – A “boat” shaped bone in the midfoot. Two joints are present: the talonavicular joint which has a complicated biomechanical function that controls flexibility of the foot and controls the arch of the foot; and the naviculocuneiform joint which can be injured in midfoot injuries and can contribute to flatfoot deformity.

Osteoarthritis – Osteoarthritis is primary arthritis of the joint and may be related to family history.

Peroneal tendon – The peroneal tendons are behind the outside bone of the ankle (the fibula). These two tendons move the foot outwards in a direction called eversion. They balance the ankle and the back of the foot and prevent the foot from turning inwards repetitively. The peroneal tendons are susceptible to injury as the ankle turns, rolls or becomes sprained because they are not as strong as the muscles and tendons on the inside of the ankle.

Posterior tibial tendon – The posterior tibial tendon and other supportive ligaments help to maintain the arch of the foot. This tendon goes behind the ankle and around the medial malleolus (a bone inside the ankle).

Rheumatoid arthritis – One of the inflammatory arthritis diseases. This is an autoimmune disorder where the patient’s immune system malfunctions and attacks the cartilage and tendons.

Sprain – An injury causing tearing of a ligament. Sprains vary in severity and can range from a partial tearing of the ligament to a complete rupture.

Sprained ankle – A rupture of one or more of the ligaments that surround the ankle.

Talus – The ankle bone. This bone sits within the ankle “Mortise” or hinge which is made up of the two leg bones, the tibia and fibula. Three joints are present: the ankle, which allows the up and down motion of the foot with the leg; the subtalar joint which allows “inversion” and “eversion” of the foot with the leg; and the talonavicular joint which has a complicated biomechanical function that controls flexibility of the foot and the arch of the foot. The talus has no muscular attachments and is mostly covered with cartilage, which makes injuries to the talus difficult to heal.

Tendon – A tendon is a structure in the body that connects muscle to bone. As the muscle contracts, it pulls on the tendon which moves the bone. Tendons are made mostly of collagen. Inflammation of a tendon is called tendonitis. Tendons can tear or rupture if they are pulled too hard by the muscle, or if they degenerate.

Tendonitis – Inflammation of a tendon. Most cases of tendonitis are caused by some type of injury, overuse or a mechanical abnormality in the foot or ankle. Treatment depends on the specific tendon involved, the extent of involvement and the length of time the symptoms have been present.

Tendonosis – A later stage of tendonitis where the tendon starts to fray and tear.

Tibia (shinbone) – The large bone of the leg that extends from the knee to the ankle.

Tibialis anterior tendon – The function of the tibialis anterior is to move the ankle upwards. It stabilizes the foot in the latter part of the stance phase of gait and extends the foot at the beginning and middle portions of the swing phase of gait.

Valgus – Tilted “outward” or away from the midline of the body. Varus – Tilted “inward” or towards the midline of the body.